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AIM: This paper is a report of a study to determine the transferability of the Management of Aggression and Violence Attitude Scale to European mental health inpatient settings. BACKGROUND: Incidents of patient aggression and violence are common in psychiatric in-patient facilities, and nurses' attitudes may play a part in how they are managed. METHODS: Nursing staff from acute psychiatric in-patient units in Switzerland and the United Kingdom completed the Management of Aggression and Violence Attitude Scale. Data were collected in the UK in 2001 and Switzerland in 2003. The Swiss sample comprised 75 respondents: 45 female, mean age 36.24, mean experience 7.35 years, 60 Registered Nurses. The United Kingdom sample was 75 respondents: 58 female, mean age 32, mean experience 5.25 years, 48 Registered Nurses. T-tests identified differences between the groups in their responses to each Management of Aggression and Violence Attitude Scale statement. RESULTS: There was 66% concordance of views between the groups. Swiss nurses were, however, more likely to regard factors internal to the patient as contributory to aggression while United Kingdom nurses perceived environmental factors to be more important. Both groups endorsed physical means of aggression management, Swiss nurses more so. CONCLUSION: There are both commonalities and differences between the attitudes of Swiss and United Kingdom nursing staff regarding patient aggression. Differences may relate to rates of aggression, variations in management approaches, training and policy. The Management of Aggression and Violence Attitude Scale is a potentially effective tool for making comparisons about perspectives on patient aggression. [ABSTRACT FROM AUTHOR]

This paper reports on an analysis of Woodlands therapy (WT), a sensory-motor therapeutic activity that aims to encourage interaction with people with moderate or severe dementia. The aims of the study were to examine: the responses of patients to the sensory experiences and play-based activities that make up a WT session; the factors that influenced their responses; and the verbal interventions employed by the staff who facilitated WT sessions. Methods derived from ethnography were used. The data comprised videotapes of five WT sessions, notes of other sessions, and discussions with staff involved with the approach. Thematic groups of patients' responses were formulated. WT mainly appears to engender the responses of attention, participation and comment. Factors that influence patients' responses are discussed. The findings indicate that staff facilitation strategies strongly influence patients' responses to WT. Verbal interventions made by staff are grouped in terms of their relative helpfulness for promoting positive responses to WT. Suggestions for practice are made for professional carers undertaking sensory-motor therapeutic activities for people with dementia. [ABSTRACT FROM AUTHOR]

Carers of people with dementia should embrace the philosophy of person-centred care and understand that social and psychological aspects of care are as important as physical care. This article discusses a three-component model that identifies the personal qualities that carers should ideally possess to deliver person-centred care to people with dementia. These qualities are empathy with the person, person-centred attitudes and a compassionate approach. The intention is that these will induce a state of cognitive security in people with dementia and enhance their sense of wellbeing. The article defines each of the personal qualities and details their component parts. It explores why person-centred care can often be difficult to achieve in practice, as well as the role of education in its promotion.

Background: Staff from a range of health and social care professions report deficits in their knowledge and skills when providing end-of-life and palliative care, and education and training has been advocated at a range of levels., Aims: To review the literature related to classroom-based and distance learning education and training initiatives for health and social care staff in end-of-life and palliative care, in terms of their target audience, extent, modes of delivery, content and teaching and learning strategies, and to identify the most effective educational strategies for enhancing care., Design: A systematic review of the literature evaluating classroom-based and distance learning education and training courses for health and social care staff in end-of-life and palliative care., Data Sources: Online databases CINAHL, MEDLINE, EMBASE and PSYCHINFO between January 2000 and July 2010. Studies were selected that discussed specific education and training initiatives and included pre-and post-test evaluation of participants' learning., Results: 30 studies met eligibility criteria. The majority reported successful outcomes, though there were some exceptions. Level of prior experience and availability of practice reinforcement influenced learning. Participative and interactive learning strategies were predominantly used along with discussion of case scenarios. Multi-professional learning was infrequently reported and service user and carer input to curriculum development and delivery was reported in only one study., Conclusions: Classroom-based education and training is useful for enhancing professionals' skills and perceived preparedness for delivering end-of-life care but should be reinforced by actual practice experience.

An acute bout of exercise prior to vaccination can improve the antibody and cell-mediated responses to influenza vaccination. The mechanisms underpinning this adjuvant effect remain unclear, and further investigation to determine the optimal exercise protocol is warranted. The aim of the current study was to determine whether exercise augmented the immune response to vaccination, and whether the timing of exercise relative to vaccination affected the efficacy of the intervention. One hundred and fifty-six (76 men) healthy participants were randomly assigned to a control group or one of three intervention groups who exercised immediately, 6h or 48 h prior to administration of a standard trivalent influenza vaccine. The exercise groups performed 50 repetitions of the eccentric portion of both the bicep curl and lateral raise movements at an intensity eliciting 85% of each participant's pre-determined concentric one repetition maxima. Antigen-specific serum antibody titres were measured at baseline and 28 days post-vaccination as indicators of the humoral response. All three viral strains elicited strong antibody responses; however, eccentric exercise did not further augment any antibody responses compared to the control group. Cell-mediated immunity at 28 days post-vaccination was determined by measuring the IFN-gamma response to in vitro stimulation of the blood with whole vaccine. There were no differences in cell-mediated immunity among the groups. Although these null findings were unexpected, they are consistent with previous research showing that exercise-induced immunoenhancement was only observed when the control group had relatively poor responses. In conclusion, it is likely that the robust immune responses to the vaccine observed in this study may have limited any further immune enhancement by exercise., (Copyright 2009 Elsevier Inc. All rights reserved.)

This paper reports on the first national UK survey of higher education provision related to dementia care. A questionnaire was distributed to lecturers in Higher Education Institutions (HEIs) in England and Wales seeking information about the amount of coverage of dementia within their pre-registration and pre-qualifying courses for health and social care professionals, and continuing professional development (CPD) courses on dementia care. Information was sought regarding the content of courses, and their relation to a published "dementia curriculum" [Pulsford et al., The contribution of higher education to dementia care, Journal of Dementia Care 11(4) (2003) 27-29]. Results show that coverage of dementia within the mental health branch of pre-registration nursing programmes is very variable, and may be related to the presence of an experienced and committed lecturer within the HEI. Coverage of dementia on adult branch programmes is limited, and sometimes non-existent, despite reported deficits in the ability of general nurses to work effectively with people with dementia. Occupational Therapists and Social Workers receive similar input to adult branch nurses. CPD courses are provided by around 70% of HEIs overall, but there is a shortage of specialised diploma and degree level courses on dementia care. Most areas of the dementia curriculum are covered in both pre-registration and CPD courses, but culture and diversity, young onset dementia, and physical health care may be less well addressed. Recommendations are made for developing higher education provision for professionals working with this group of people.

This paper reports on a survey of practitioners who act as mentors to student nurses from a Higher Education Institution in Northern England. The aims of the survey were to gain a profile of mentors, and to seek their views regarding their degree of support in undertaking the mentoring role, and their experience of mentors' update sessions. Respondents were experienced as mentors. As a group, they felt supported by their work colleagues, but fewer felt that they had adequate support from the HEI or their managers. Respondents wanted more time for mentoring activities, closer links with the HEI before, during and after practice placements, and more user friendly assessment documentation. Respondents did not report difficulty in spending enough time working with students, although this is a frequent complaint of students. Mentors update sessions were often not attended, either through staff shortages, or through lack of information.

This paper reviews the literature pertaining to the provision of therapeutic activities for elderly people suffering from dementia. It relates both the provision of such activities, and the types of activity done, to the values and beliefs held by nurses and other professional carers. The range of therapeutic activities cited in the literature is explored, and reasons why activities are sometimes not offered to patients are discussed. Finally, research findings into the effectiveness and value of therapeutic activities for this group of people are reviewed.

This paper discusses an attempt to introduce liberal studies into a Project 2000 nurse education course. The paper reviews the origins of liberal studies and other attempts to nurture the 'whole person' in further and higher education, and describes a 'contract learning' approach to liberal studies adopted at one college of nursing. The results of an evaluative questionnaire completed by students about the liberal studies component of the course are outlined, and the implications discussed.

Role play is regarded as being a useful learning method for assisting student nurses to improve their interpersonal skills. It can provoke strong feelings in students both for and against its use, and the participation rate in role play exercises tends to be low. This paper describes an experiential exercise designed to introduce the concept of role play to students in a way that is hopefully less threatening than role play 'proper', with the aims of encouraging students to discuss the issues around the use of role play, and to reach a decision as to whether they will participate in role play in the future, and on what terms. It is hoped that the opt-out rate from role playing will be reduced, through students becoming more familiar with the method.

Experiential learning methods are increasingly being used in nurse education, particularly in the field of interpersonal skills training. One basic tenet of experiential learning is that participation in such learning should always be voluntary. This tenet raises issues for nurse teachers committed to this approach who come upon a student who persistently opts out of taking part in experiential exercises, leading sometimes to indirect attempts to coerce students into participating. This paper examines these issues in the light of evidence as to the effectiveness of experiential learning methods. It concludes that attempts to coerce students into participation can never be justified, but non-participation should be minimised if the teacher employs good practice in conducting experiential learning.